Article; What Killed Dr. Atkins (N.Y. Times)

What Killed Dr. Atkins, and What Keeps the Issue Alive?

By N. R. KLEINFIELD

Published: February 11, 2004


Was he fat or svelte or maybe a tad chubby? Was it really a slip on the
ice or could it have been something else - even, dare it be said,
something he ate?

Now there are confidential documents passed to the news media, and
still more dueling authorities, not to mention the ticklish matter of
the mayor and the doctor's widow and the promised steak dinner.


Oh the mess goes on and on like a seven-course meal.

Dr. Robert Atkins, the diet doctor who popularized the notion that
dieters could eat fat and lose weight, has been dead for nearly a year,
after he fell on some ice and hit his head last April, yet indecorous
questions about his health and, yes, his weight persist, and the mayor,
who hasn't even been on the diet, can't seem to stay out of it all.

The latest twist is the publication in The Wall Street Journal on
Tuesday of details from Dr. Atkins's confidential medical report. The
report concludes that Dr. Atkins, 72, had a history of heart attack and
congestive heart failure and notes that he weighed 258 pounds at death.

The release of the report by New York City officials outraged the
Atkins people. It also annoyed Mayor Michael R. Bloomberg, already on
delicate ground in Atkins matters. "What happened is we made a
mistake," said Ellen Borakove, spokeswoman for the city medical
examiner's office. Late last year, the office received a request for
Dr. Atkins's medical report from Dr. Richard Fleming of the Fleming
Heart and Health Institute in Omaha, Neb. On Dec. 22, a member of the
records staff mistakenly mailed it out.

While cause and manner of death are public information, medical reports
are not. They are to be shared only with the next of kin or anyone
authorized by the next of kin, physicians or medical facilities that
treated the deceased, or state or federal facilities that legitimately
need it.

So it was fine to tell the world that the cause of death was "blunt
impact injury of head with epidural hematoma" because Dr. Atkins "fell
from upright position," but that's it.

Dr. Fleming was not a treating physician, and, according to Ms.
Borakove, did not say he was. A critic of the Atkins diet, he passed
the report on to a group he was acquainted with, the Physicians
Committee for Responsible Medicine, which promotes a vegetarian diet
and denounces the Atkins plan.

The Physicians Committee gave the report to The Journal. Ms. Borakove
said that a television station in New York apparently also has a copy,
because it called her last week. (The Physicians Committee furnished a
copy yesterday to The Times.)

The report, based on an external examination of the body and some
hospital information, said Dr. Atkins had a history of heart attack,
congestive heart failure and hypertension. His wife objected to an
autopsy, Ms. Borakove said, so none was performed.

Responses to the report's release came quickly from Atkins quarters.
Dr. Stuart Trager, chairman of the Atkins Physicians Council, a group
of physicians who work as consultants to the Atkins organization, said
the Journal article "was based on incomplete personal medical records
that were illegally delivered to the newspaper in violation of federal
law."

He said Dr. Atkins did not have a history of heart attack, nor was he
obese. He said that Dr. Atkins weighed 195 pounds the day after he
entered the hospital following his fall, and that he gained 63 pounds
from fluid retention during the nine days he was in a coma before he
died. Dr. Trager said Dr. Atkins did have cardiomyopathy, a heart
muscle disease that was probably caused by a virus, not by what he ate.
While Dr. Atkins had an episode of cardiac arrest the year before his
death, Dr. Trager said, he was unaware that he had had any history of
heart attack.

"Old age was not particularly kind to him," he said. "This
cardiomyopathy was a real bugger. But the physicians who were treating
him had no reason to think it was diet related."

Veronica Atkins, Dr. Atkins's widow, issued a statement yesterday
expressing her horror at "unscrupulous individuals" who "continue to
twist and pervert the truth." She added, "I have been assured by my
husband's physicians that my husband's health problems late in life
were completely unrelated to his diet or any diet."

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